| About 55,000 West Virginians with disabilities will face sweeping changes using their Medicaid benefits.
The state Department of Health and Human Resources is planning on transferring the medical and behavioral health benefits of those receiving Supplemental Security Income to managed-care organizations.
Watch-dog groups say the changes will affect the most fragile WV recipients.
The state says they plan to start the transition process in July, but that recipients' benefits won't change until 2011.
They say the change is meant to help integrate behavioral health with physical health services.
Advocates for people with disabilities and mental illness worry that the plan could lead to fewer services for people who receive Medicaid, the federal/state program that provides health care for the poor.
Advocates also say the changes could confuse a vulnerable population and make them have to find new doctors, counselors and pharmacists.
Many people receiving SSI are chronically mentally ill, severely disabled and some are homeless.
"Lots of folks who will come under this new plan are pretty fragile," said Clarice Hausch, director of West Virginia Advocates, who is expressing concern about continuity of care.
SSI members who also qualify for Medicare and people receiving long-term care services won't be impacted by the change.
In managed-care plans, people must visit doctors, pharmacists and other health providers who have signed up with a managed-care company's network.
The changes could particularly impact patients in rural areas.
That's different from the current fee-for-service model, where someone can visit any provider who accepts Medicaid.
State media is saying with the transition set to start in two months, state officials have not initiated public discussions or made a formal announcement about the change.
"It's all a mystery, and DHHR has really not provided sufficient education to either the providers, the people on Medicaid, or advocates for people who are going have to go through this change and navigate this changeover," said Jennifer Wagner, a lawyer for Mountain State Justice, which represents low-income people.
House Health and Human Resources Chairman Don Perdue, D-Wayne, said he hopes the state won't repeat mistakes made when it revamped Medicaid in 2007.
"We saw with the Medicaid redesign that we did a very, very poor job," Perdue said, "In terms of instructing the population we're trying to reach, in terms of how they can access the benefits."
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